HAND HYGIENE
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FINGERNAILS AND SKIN CONDITION
• Maintain short, natural fingernails with tips no longer than
2 mm (0.08 inch).
• Do not wear artificial fingernails or extenders.
• Follow your facility’s policy and procedure on use of
fingernail polish, including ultraviolet-cured (gel) nail polish.
• Use moisturizing skin care products approved by your health
care organization to prevent hand dermatitis.
• Completely dry your hands before donning gloves.
• In the absence of visible soil, disinfect your hands with an
alcohol-base hand rub.
• Wear cotton glove liners under non-sterile gloves and sterile
cotton glove liners under sterile gloves, if desired.
Having unhealthy skin or fingernails may impede the
removal of microorganisms from the hands during
hand hygiene. Transmission to the patient of microorganisms
that are harbored in unhealthy skin or fingernails may result in
the patient developing a health care-associated infection.
Copyright © 2016 AORN, Inc. All rights reserved. Used with permission.
HAND HYGIENE
• Perform hand hygiene:
- before and after patient contact
- before performing a clean or sterile task
- after risk for blood or body fluid exposure
- after contact with patient surroundings
- when hands are visibly soiled
- before and after eating
- after using the restroom
• For hand washing:
- remove jewelry from hands and wrists
- wet hands thoroughly with water (avoid using hot water)
- apply the amount of soap needed to cover all surfaces of
the hands
- rub hands together vigorously covering all surfaces of the
hands and fingers for a least 15 seconds
- rinse with water to remove all soap
- dry hands thoroughly with a disposable paper towel
- use a clean paper towel to turn off the water
• When using an alcohol-based hand rub:
- remove jewelry from hands and wrists
- apply the amount of alcohol-based hand rub recommended
by the manufacturer to cover all surfaces of the hands
- rub hands together, covering all surfaces of the hands and
fingers until dry
Hand hygiene is critical for preventing the transmission
of microorganisms from the hands of perioperative
team members to the patient and the environment.
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SURGICAL HAND SCRUB SURGICAL HAND RUB
• Follow the manufacturer’s instructions for use when using • Follow the manufacturer’s instructions for use.
a surgical hand scrub.
• Remove jewelry from hands and wrists.
• Remove jewelry from hands and wrists.
• Don a surgical mask.
• Don a surgical mask.
• If hands are visibly soiled, wash hands with soap and water.
• If hands are visibly soiled, wash hands with soap and water.
• Remove debris from underneath fingernails using a
• Remove debris from underneath fingernails using a disposable nail cleaner under running water.
disposable nail cleaner under running water.
• Dry hands and forearms thoroughly with a disposable
• Apply the amount of surgical hand scrub product paper towel.
recommended by the manufacturer to the hands and
forearms using a soft, nonabrasive sponge. • Apply the surgical hand rub product to the hands and
forearms according to the manufacturer’s instructions for use
• Scrub arms for the length of time recommended by the
(amount, method, time).
manufacturer.
• Allow hands and forearms to dry completely before using
• Visualize each finger, hand, and arm as having four sides, and
sterile technique to don a surgical gown and gloves.
wash all four sides effectively, keeping the hands elevated.
• Scrub for length of time recommended by the Surgical hand antisepsis is the primary line of defense to
manufacturer. protect the patient from pathogens on the hands of
perioperative team members, whereas sterile surgical gloves are
• Avoid splashing surgical attire.
the secondary line of defense. Due to the risk for glove failure,
• Discard sponges if used. the performance of surgical hand antisepsis is critical for the
• Rinse hands and arms under running water in one prevention of surgical site infections.
direction from fingertips to elbows.
• Hold hands higher than elbows and away from surgical attire.
• In the OR or procedure room, dry hands and arms with
a sterile towel using sterile technique before donning a
surgical gown and gloves.
Surgical hand antisepsis removes soil and transient
microorganisms from the hands and suppresses the
growth of resident microorganisms to reduce the risk that the
patient will develop a surgical site infection.

Copyright © 2016 AORN, Inc. All rights reserved. Used with permission. Page 2